Management of STIs/RTIsChapter 9. STI/RTI complications related to pregnancy, miscarriage,
induced abortion, and the postpartum period

Vaginal discharge in
pregnancy and the postpartum period

Vaginal discharge as a symptom or sign of RTI presents different
challenges during pregnancy, because physiological changes during
pregnancy can affect the normal microbiological environment (flora) of
the vagina. For example, discharge may be more abundant and yeast
infection is more common. Women with vaginal discharge should be
carefully questioned and examined to make sure that the discharge is not
an early sign of a more serious problem. For example:

In early pregnancy, discharge may mask spotting or light bleeding
that could indicate ectopic pregnancy, threatened abortion, or
cervical cancer.

A watery discharge in late pregnancy could be amniotic fluid from
ruptured membranes.

A careful history and examination will usually provide clues that
will help distinguish simple vaginitis from more serious conditions.
When discharge is accompanied by bleeding, fever, abdominal pain or
amniotic fluid leakage, the patient should be managed or referred for
possible sepsis.

If pregnancy complications have been ruled out, all women with
vaginal discharge should be treated for bacterial vaginosis,
trichomoniasis and yeast infection. Yeast infection is very common
during pregnancy and is often recurrent, so if a woman comes back with
the same symptoms, she should be treated for yeast infection only.